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Step III

Step III - GI 10

Elderly advanced DM pt c/o nausea, bloating and vomiting after meals gastroparesis
MC S/S gastric ulcer PAIN
Next step in evaluating gastroparesis Upper GI barium eval
Tx for gastroparesis Erythromycin and metoclopramide
Infant 6wks – 9mos presents w/ constipation, poor feeding, decreased activity, drooling Infant botulism; (MCC is weakness but constipation is close 2nd)
AA male c/o mid-epigastric pain, weight loss, anorexia, and a palpable, nontender gallbladder (Courvoisier’s sign), leg swelling, tender to touch, and jaundice PANCREATIC ca
Trousseau’s sign is aka and a/w Migratory thrombophlebitis; pancreatic CA
Pancreatic ca is more common in what types of patients AAM, DM, smokers
abdominal pain that is more diffuse and persistent c/w RUQ of cholecystitis. jaundice, anorexia, and weight loss GB CA
most common independent environmental risk factor associated with pancreatic cancer smoking
Smoking increases the risk of carcinoma of what organs lung, esophagus and oral cavity, larynx, pharynx, bladder, kidney, cervix, vulva, penis, anal cavity, pancreas
The two most common causes of acute pancreatitis are gallstones >> alcoholism
What happens to Ca in pancreatitis Lowered (sequestered)
ataxia, ophthalmopathy and confusion in an active alcoholic Wernicke’s
Tx for Wernicke’s thiamine
hallucinations, tremors, confusion in alcoholic EtoH W/D
Lethargy and asterixis Hepatic encephalopathy
Asian, >50yo, n/v, ab pain, eye pain, blurry vision Acute angle glaucoma
ocular pain, nausea/vomiting, and a history of intermittent blurring of vision with halos +/- conjunctival injection, corneal epithelial edema, mid-dilated nonreactive pupil Acute angle glaucoma
precipitating factors for acute angle glaucoma Drugs (antidepressants, sympathomimetics, anticholinergics), dim light and RAPID correction of hyperglycemia
MCC lower GI bleeding in pts >60yo Diverticulosis > Angiodysplasia
Where is Angiodysplasia most commonly found Right side (cecum / asc colon)
Angiodysplasia is a/w development of what other vascular dz Aortic stenosis
the combination of calcific aortic stenosis and GI bleeding due to colonic angiosydplasia is called Heyde’s syndrome
sequelae of GERD BARRETTS
epigastric burning that is localized and relieved by taking antacids or by drinking milk w/ atypical chest pain PUD
IBD pts are als susceptible to what other dz d/t sharing of HLA-B27 Ankylosing spondy
Rectal involvement occurs in which IBD UC
Endoscopy revealing erythema and friability is characteristic of which IBD ulcerative colitis
Apthoid deep ulcers are seen in which IBD Crohns
The most sensitive test to detect carcinoma of the pancreatic head is ERCP
Radiographic evidence on abdominal film showing presence of both inner and outer walls of the bowel is indicative of what and called what sign Pneumoperitoneum 2nd from perforated duodenal ulcer; Rigler sign
Sudden onset of severe abdominal pain w/ epigastric tenderness + signs of acute peritonitis + FOBT(+) Perforated duodenal ulcer
Management of patients with upper GI hemorrhage should depend on the acuity of the patient but should include a set of basic parameters, including placement of an NG tube, IV fluid administration, placement in the ICU, and immediate endoscopy + PPI
Vomiting acid base disorder and K+ level Alkalosis, low K
Diarrhea / laxative use acid base disorder and K level Acidosis, low K
renal failure, renal tubular acidosis, DKA and injuries such as burns and rhabdomyolysis lead to what acid base dx and level of K acidosis, K
confirmatory test for lactose intolerance Hydrogen breath test
colon ca screening for HNPCC starts at what age 21 yo or 10 years younger than youngest age of colorectal CA family member
Created by: DrINFJ